About the SeniorAdvisor.com 2014 In-Home Innovation Scholarship: We started the scholarship program to bring awareness of the unique benefits and challenges of in-home caregiving for seniors to younger generations. The questions posed by the scholarship encouraged our nation’s future caregivers to present solutions for improving home care in the United States. College-aged students were required to answer one of the three essay topics below and provide a short bio as part of their scholarship application. Read the winning essays here.

How can your major of study improve the lives of seniors receiving in-home care services?

Essay response by Eric Shi, Western University of Health Sciences

For many of the seniors in this country, foot and ankle health may be the least of their concerns on what can already be a very long list of health conditions. However, healthy feet are fundamental to the quality of life. Healthy feet keep patients active, prevent blood clots, and help maintain cardiovascular and respiratory function. Podiatrists are doctors that specialize in the clinical and surgical care of the foot and ankle. This includes all skin, neurological, vascular, and musculoskeletal issues. As a 4th year podiatric medical student, I am studying to enter into a profession that will have the tools to improve the quality of life for seniors receiving in-home care services.

Routine nail care is a basic yet fundamental need for many seniors. Onychomycosis is a fungal infection of the toenails resulting in thick, hard to trim nails that can often become ingrown. This issue plagues almost 90% of the elderly, and is very difficult to cure once infected. Oftentimes, routine nail debridement is the only treatment. Unfortunately, the nails are so thick that the average nail clipper cannot cut them. Apart from the fact that they are aesthetically unpleasing, long, untrimmed nails oftentimes get caught in clothing and can make putting on pants and socks difficult. Long nails can also result in accidental cuts and scrapes to the leg. For many seniors, reaching down to trim their own nails is not possible due to back problems or difficulty with sight. Cutting nails on their own could result in injury. Podiatrists can provide in-home services to trim nails on a routine basis.

In addition to nails, corns and calluses are another area in need of routine care. Calluses are thickened areas of skin that grow on feet due to pressure. Left untrimmed, calluses can make walking painful, and can irritate and create and ulcer on the bottom of the foot. Podiatrists use surgical-grade scalpels to sharply trim down the callus down to a comfortable level.

Diabetes is a disease that has greatly impacted our generation. Affecting 9.3% of Americans, that number triples to nearly 27% of seniors age 65 and older1. Two major complications of diabetes are peripheral arterial disease and peripheral neuropathy. In peripheral arterial disease, elevated blood sugar destroys the small blood vessels in the foot. Poor blood flow to the foot and toes can result in gangrene, which is tissue death, which may necessitate amputation. Podiatrists are trained to surgically treat such conditions. Peripheral neuropathy is when high blood sugar levels destroy the nerves in the feet, which leaves the foot numb and vulnerable to cuts and ulcers that can go unnoticed. Nerves responsible for sweat and keeping the foot moist are also damaged, resulting in dry, scaly, and cracked feet prone to developing into wounds and getting infected. A deep infection that penetrates to bone would necessitate amputation, further lowering the quality of life for patients.

Podiatrists are committed to limb preservation. They provide the tools necessary for preventing wounds to develop in the first place. They can prescribe special moisturizers and ointments for keeping the skin healthy. Routine foot screenings help patients identify “hot spots”, or areas at risk for developing a wound. For those already with wounds, podiatrists use specialized dressings, topical growth factors, surgical debridement, and hyperbaric oxygen therapy to close wounds quickly. Another area of specialty for podiatrists is shoegear. Podiatrists can help diabetic patients obtain custom extra-depth orthopedic shoes as well as orthotics, which are insoles with the proper padding to conform to the unique shape of each patient’s foot. These shoes offload areas of high pressure to prevent wounds from developing.

Podiatry is a unique, steadily growing profession that will have the skills to care for the feet and ankles of our aging population. Whether it’s something as routine as trimming nails or as invasive as performing an amputation of infected bone, podiatrists provide the skills that will greatly improve the lives of seniors receiving in-home care services.

About Eric

Eric is currently a 4th year podiatry student at Western University of Health Sciences in Pomona, California.